| NPI | 1477911816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: AL L.4913SP) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: AL L4263F) |
| Enumeration Date | 2016-01-31 |
| Last Update Date | 2019-07-08 |